Provider Demographics
NPI:1164653341
Name:THE VISITING NURSE ASSOCIATION OF GREATER PHILADELPHIA
Entity Type:Organization
Organization Name:THE VISITING NURSE ASSOCIATION OF GREATER PHILADELPHIA
Other - Org Name:HOSPICE OF PHILADELPHIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-581-2046
Mailing Address - Street 1:4601 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4636
Mailing Address - Country:US
Mailing Address - Phone:215-473-0772
Mailing Address - Fax:215-473-7910
Practice Address - Street 1:501 S 54TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-1900
Practice Address - Country:US
Practice Address - Phone:215-581-2046
Practice Address - Fax:215-581-2049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207Q00000X
207RH0002X
PA157499251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007743370021Medicaid
PA391574Medicare Oscar/Certification
PA1007743370021Medicaid
PA1007743370021Medicaid